Nutritional Assessment in Obesity and Pregnancy

Nutritional Assessment and Recommendations

• For patients with obesity, the DASH eating pattern recommends:
  • Reducing intake of less healthy fats to less than 25% of the diet's energy
  • Increasing the proportion of low-energy-dense foods, such as vegetables and fruits (9-12 servings/day) and low-fat dairy products (2-3 servings/day)
• For pregnant clients, nutritional assessment should consider:
  • Macro- and micronutrients
  • Maternal health, fetal growth, physical activity levels, and gestational stage
  • Weight at conception, as an unhealthy weight increases the risk of complications

Dietary Recommendations for Specific Conditions

• For patients with gestational diabetes:
  • Eat a variety of foods, including fresh fruits and vegetables
  • Limit fat intake to 30% or less of daily calories
  • Watch portion sizes
  • Choose whole grain cereals, bran, and oats for breakfast
  • Include low GI fruits, such as apples, pears, citrus, and stone fruits
• For patients with Celiac disease:
  • Avoid foods that contain wheat, rye, or barley
  • Include a variety of naturally gluten-free foods, such as fresh fruits, vegetables, milk, cheese, yogurt, eggs, unprocessed meats, poultry, fish, beans, nuts, oils, and sugar

Breastfeeding and Infant Nutrition

• Breastfeeding is recommended for the first six months of a baby's life
• Breastfeeding instructions for mothers:
  • Start breastfeeding as soon as possible after birth

Dietary Management for Prevention of Stone Formation

• Eat calcium-rich foods
• Reduce sodium intake
• Limit animal protein
• Avoid stone-forming foods, such as beets, chocolate, spinach, rhubarb, tea, and most nuts that are rich in oxalate

Standard Heart Healthy Diet

• Eat less saturated fat
• Cut back on fatty meats and high-fat dairy products
• Cut down on sodium (salt)
• Get more fiber by eating vegetables, fruits, beans, and whole grains

Dietary Recommendations for Preventing Diverticulosis

• Eat a high-fiber diet to soften stool and prevent constipation
• Increase fiber intake to decrease pressure in the colon and prevent flare-ups of diverticulitis

Dietary Recommendations for Lowering Cholesterol Levels

• Eat a variety of vegetables, fruits, and whole grains
• Include a variety of healthy protein-rich foods, such as fish, seafood, legumes, nuts, and seeds
• Choose unflavored milk, yogurt, and cheese
• Use healthy fats and oils
• Flavor foods with herbs and spices instead of adding salt

Dietary Modifications for Specific Conditions

• For clients with gout:
  • Eat more fruits, vegetables, and whole grains, which provide complex carbohydrates
  • Avoid foods and beverages with high-fructose corn syrup
  • Limit consumption of naturally sweet fruit juices
  • Stay well-hydrated by drinking water
• For clients with IBD:
  • Drink 8-10 glasses of water
  • Eat high-fiber carbohydrates, such as oat bran, legumes, and barley
  • Include proteins like lean meats, fish, eggs, nuts, poultry, and soy
  • Eat a variety of fruits and vegetables

Parenteral Nutrition and Bolus Feeding

• For patients with elevated blood glucose on parenteral nutrition:
  • Target blood glucose levels of 7.8 to 10.0 mmol/L (140 to 180 mg/dL)
• For administering a bolus feeding to a client with a gastrostomy tube:
  • Insert the syringe tip into the feeding tube or bolus extension set
  • Flush tubing with 3-5 ml of water or as directed by the nurse or doctor
  • Slowly pour the formula into the syringe
  • Unclamp the feeding tube

Dietary Recommendations for Liver Dysfunction

• For clients with liver dysfunction on parenteral nutrition:
  • Avoid calorie overload and toxic components in the TPN solution
  • Avoid overfeeding, which can lead to hepatic steatosis and hepatitis
  • Use healthy fats like omega-3 fatty acids, olive oil, and canola oil
  • Eat skinless, seedless, dark-colored fruits and vegetables

Standard Postoperative Diet

• Clear liquid diet post-surgery:
  • Water
  • Ice chips
  • Non-carbonated, non-caffeinated, sugar-free liquids
• Standard diet for clients with pancreatitis:
  • Eat a low-fat diet
  • Try to eat 4-6 small meals and snacks each day
  • Choose lean meats
  • Drink or eat non-fat or low-fat milk, yogurt, cheese, or other milk products
  • Eat a variety of vegetables and fruits
  • Eat whole grain cereals, breads, crackers, rice, or pasta